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I picked up a new Airsense 10 autoset a couple of days ago and had some questions. Actually I have quite a few questions but I'll start with the basics.

Some background:

I was dx'd in 1998 with OSA and prescribed a cpap. After 4 weeks of trying I could not obtain compliance and my doctor gave me an ancient bipap trade-in that was sitting on his shelf to take home and try. It was love at first sight and I still have that behemoth as a backup to my backup.

Since that day I have been compliant on a bipap with the vast majority of those years using a respironics bipap plus M-series and nasal pillows with custom conjo headgear. Outside of the frustrating heated humidifier that has 5 dial positions but only two real levels (off and too warm) this machine has served me well. It's spent a fair amount of time traveling and used in 12volt situations.

Recently I've been feeling like I should have a new sleep study and see if my pressures need adjusting as it has been many years since the last study.

So, I had an appointment with my sleep doctor (same fellow as in 1998) and he informed me that there would be no sleep study and went into a mini rant about how sleep studies are out-dated and usually not needed with the new auto type machines and user available data. (he is a bit eccentric and likes to talk)

As a long time user I have no compliance requirements and he prescribed me an Airsense 10 autoset cpap with 8-20 pressure.

Off to the DME I go to pick up the machine. Met with a nice fellow who seemed pretty knowledgeable but I did leave there with some uneasiness.

1) The first Airsense unit he brought out to give me was broken right out of the box. The round dial would stick down when pushed and did not release. He retrieved another new machine that worked.

2) He informed me that this was the latest version of the airsense, only four months old in fact. Can you tell me what is different on this latest version vs previous versions?

3) When I told him my previous machine of many years was a bipap he reacted with surprise and a little alarm. He asked me why I was getting this cpap instead of the bipap. I told him that’s what I thought the doctor had prescribed and he looked up the prescription and verified that the doctor was very specific on what machine was required. Is it normal to go from a bipap machine to a cpap machine with these autosense type machines?

4) He then told me the machine would automatically beam my data to my doctors own website. When pressed on this issue he said the unit contained a cellular modem and transmitted my patient data to the doctors website. Typically I’m not a tin foil person but I find myself a little uneasy about this ‘feature’. What is the “doctors own website” exactly? I don’t mind bringing the data into the office on a card as the office is real close but I don’t see any way of turning the transmitting off other than to put the machine into airplane mode. The problem with this is the machine continually harangues me to turn airplane mode off.

5) I tried the machine last night and it didn’t work. I was told all I had to do is turn it on and the magic would happen. I have the type of mask set properly and did a mask fit test and that was fine. One of the most frustrating things was the blasted screen would only stay light for a few seconds. Absolutely maddening. How do I program this thing to stay on so I can see it? I called the DME guy but off course he is gone for the weekend already. The machine will turn on by the pressure just sits there and stays at 4. I’m sure this probably just user error and I’m wondering if you all could shed some light on this? I did try laying there with the mask on but I simply could not breathe. This is in stark contrast to my bipap that senses the beginning of the inhalation process and the exhalation process and adjust the pressure accordingly. What am I doing wrong?

Thanks for reading all this and any light you can shed on the subject would be appreciated.

I picked up a new Airsense 10 autoset a couple of days ago and had some questions. Actually I have quite a few questions but I'll start with the basics.

Some background:

I was dx'd in 1998 with OSA and prescribed a cpap. After 4 weeks of trying I could not obtain compliance and my doctor gave me an ancient bipap trade-in that was sitting on his shelf to take home and try. It was love at first sight and I still have that behemoth as a backup to my backup.

Since that day I have been compliant on a bipap with the vast majority of those years using a respironics bipap plus M-series and nasal pillows with custom conjo headgear. Outside of the frustrating heated humidifier that has 5 dial positions but only two real levels (off and too warm) this machine has served me well. It's spent a fair amount of time traveling and used in 12volt situations.

Recently I've been feeling like I should have a new sleep study and see if my pressures need adjusting as it has been many years since the last study.

So, I had an appointment with my sleep doctor (same fellow as in 1998) and he informed me that there would be no sleep study and went into a mini rant about how sleep studies are out-dated and usually not needed with the new auto type machines and user available data. (he is a bit eccentric and likes to talk)

You have an enlightened doctor. Be happy.

Quote:As a long time user I have no compliance requirements and he prescribed me an Airsense 10 autoset cpap with 8-20 pressure.

Off to the DME I go to pick up the machine. Met with a nice fellow who seemed pretty knowledgeable but I did leave there with some uneasiness.

1) The first Airsense unit he brought out to give me was broken right out of the box. The round dial would stick down when pushed and did not release. He retrieved another new machine that worked.

2) He informed me that this was the latest version of the airsense, only four months old in fact. Can you tell me what is different on this latest version vs previous versions?

The Airsense is itself the latest machine. Latest version may refer to a firmware upgrade.

Quote:3) When I told him my previous machine of many years was a bipap he reacted with surprise and a little alarm. He asked me why I was getting this cpap instead of the bipap. I told him that’s what I thought the doctor had prescribed and he looked up the prescription and verified that the doctor was very specific on what machine was required. Is it normal to go from a bipap machine to a cpap machine with these autosense type machines?

Depends upon how much pressure difference you require between IPAP and EPAP. The machine you were given can have its ERP set to 0,1,2,3. Giving a BiPAP to a person who is non-compliant on CPAP was routine. Likely you do not need it. I believe the A10 series Auto Bilevel is called Aircurve.

Quote:4) He then told me the machine would automatically beam my data to my doctors own website. When pressed on this issue he said the unit contained a cellular modem and transmitted my patient data to the doctors website. Typically I’m not a tin foil person but I find myself a little uneasy about this ‘feature’. What is the “doctors own website” exactly? I don’t mind bringing the data into the office on a card as the office is real close but I don’t see any way of turning the transmitting off other than to put the machine into airplane mode. The problem with this is the machine continually harangues me to turn airplane mode off.

The cellular modem is built into all A10s. There is a way to disable it; but, you'll void the warrantee. Others feel uneasy about the "Big Brother Aspect." Should I tell you that your doc can change your machine settings by remote access?

Quote:5) I tried the machine last night and it didn’t work. I was told all I had to do is turn it on and the magic would happen. I have the type of mask set properly and did a mask fit test and that was fine. One of the most frustrating things was the blasted screen would only stay light for a few seconds. Absolutely maddening. How do I program this thing to stay on so I can see it? I called the DME guy but off course he is gone for the weekend already. The machine will turn on by the pressure just sits there and stays at 4. I’m sure this probably just user error and I’m wondering if you all could shed some light on this? I did try laying there with the mask on but I simply could not breathe. This is in stark contrast to my bipap that senses the beginning of the inhalation process and the exhalation process and adjust the pressure accordingly. What am I doing wrong?

Turn on the room light to adjust; or use a flashlight. The backlight is momentary. As for 4 -- my guess is the RAMP function is set to ON. Turn it Off so it will start at the 8 that it was set to.

Quote:Thanks for reading all this and any light you can shed on the subject would be appreciated.

Wayne

Request the clinicians manual from the link at the top of page. Get the RAMP turned off.

Welcome to the forum. Can you recall what your biPAP settings were? That might give us a hint at where to start with the APAP. There are of course significant differences.

The Airsense 10 Autoset is similar to the S9 that preceded it, but has an integrated humidifier and built in modem. It produces full efficacy data on the SD card, and you can read the results of your therapy with the free Sleepyhead software. I recommend you download this: http://www.sleepfiles.com/SH2/

You can request the clinician menu which will describe the operation of your machine and access to the hidden clinical menu where you can reset pressures and make other changes. You can request the clinician manual by sending an email to: apneaboard@gmail.com and put "Setup Manual" (without the quotes) in the subject line. Then, ResMed AirSense 10 AutoSet in the body.

Your machine is probably set to 4 cm minimum, 20 cm maximum APAP pressure. Your therapy will be better optimized if you narrow that range to your therapeutic pressure. The Autoset offers 0 to 3 cm exhalation pressure relief called EPR. You can set that to 3 and it will act similar to your exhale pressure you had before, except it doesn't have the ability to offer more than 3 cm pressure relief, while your BiPAP was able to be set at any pressure difference you found comfortable or effective.

The data sent over the cellualar service is mainly compliance, settings and basic AHI data in encrypted for to a Resmed operated site where your doctor or DME can retrieve the data. Your machine also produces detailed waveform data and a breakdown of apnea events. This is recorded on the SD card and is not transmitted.

Other members are much more familiar with the Resmed machine and will offer further ideas. Good luck and welcome.

Hi star searcher,
WELCOME! to the forum.!
What made them decide that you needed a BIPAP machine when you got your original one? It's odd that they would give you an APAP instead of a bi-level machine.
Hopefully, this AirSense 10 AutoSet will work for you.
Hang in there for more suggestions and answers to your questions and much success to you as you continue and fine tune your CPAP therapy.

(04-03-2015, 06:06 PM)Sleeprider Wrote: Welcome to the forum. Can you recall what your biPAP settings were? That might give us a hint at where to start with the APAP. There are of course significant differences.

Bipap settings. IP: 14.0, EXP: 6.0, Ramp: off. I change the IP up or down one half point each winter/summer cycle.

Quote:The Airsense 10 Autoset is similar to the S9 that preceded it, but has an integrated humidifier and built in modem. It produces full efficacy data on the SD card, and you can read the results of your therapy with the free Sleepyhead software.

You can request the clinician manual by sending an email to: apneaboard@gmail.com and put "Setup Manual" (without the quotes) in the subject line. Then, ResMed AirSense 10 AutoSet in the body.

Thanks, I will do both of those.

Quote:The data sent over the cellualar service is mainly compliance, settings and basic AHI data in encrypted for to a Resmed operated site where your doctor or DME can retrieve the data. Your machine also produces detailed waveform data and a breakdown of apnea events. This is recorded on the SD card and is not transmitted.

That's interesting. I don't have to prove compliance as I'm a long time user and have been with the same insurance company for years. At least that's what the insurance company told me. Though I still have to rent the machine to purchase, which they claim is the case for everybody regardless of experience.

If I understand you correctly, the data my doctor would need to verify the effectiveness of the therapy is actually on the SD card only?

Man, you guys are fast with the replies, thanks for all the help. I need to get started on your advice and will report back.

(04-03-2015, 07:27 PM)trish6hundred Wrote: Hi star searcher,
WELCOME! to the forum.!
What made them decide that you needed a BIPAP machine when you got your original one? It's odd that they would give you an APAP instead of a bi-level machine.
Hopefully, this AirSense 10 AutoSet will work for you.
Hang in there for more suggestions and answers to your questions and much success to you as you continue and fine tune your CPAP therapy.

I could not exhale with the continuous pressure blowing on the cpap machine.

My wife's bipap machine broke on a recent business trip and she has had to resort to her backup original cpap machine. Needless to say she is anxious for me to get this new APAP machine dialed in so she can abscond with my old bipap.

(04-03-2015, 06:06 PM)Sleeprider Wrote: Welcome to the forum. Can you recall what your biPAP settings were? That might give us a hint at where to start with the APAP. There are of course significant differences.

Bipap settings. IP: 14.0, EXP: 6.0, Ramp: off. I change the IP up or down one half point each winter/summer cycle.

Hi star searcher.

Man oh man, you are accustomed to having Pressure Support (the pressure boost during inhalation) be around 8 cm H2O. That is huge.

If we have normal lungs and a clear airway (open, not obstructed or collapsed), a Pressure Support of 10 cm H2O will do for us just about all the work of breathing, and a PS of 8 will do for us perhaps 80% of the work of breathing, meaning we need provide only 20% of the work of breathing. I think you are probably going to miss that, big time.

I have an ASV machine which is able to treat central apneas (as well as obstructive apneas). When I am in the middle of what would have been a central apnea, the ASV machine increases Pressure Support to around 9 or 10 to do for me all the work of breathing. Without any effort of my own, the difference of 9 or 10 between EPAP and IPAP keeps me ventilated adequately.

The point is that a Pressure Support of 3 instead of 8 is a huge difference, and you will likely feel like you are struggling to breathe.

The Auto machines like the PRS1 (Philips Respironics System One) Auto with A-Flex And Heated Tube or the ResMed AirSense 10 AutoSet allow not more than around 3 cm H2O reduction in pressure during exhalation. The max EPR (Exhalation Pressure Relief) on an AutoSet is 3, which reduces the effort needed to breathe by only perhaps 30 percent.

I recommend you really should ask your doctor to change your prescription to a PRS1 BiPAP Auto or a ResMed AirCurve 10 Auto, because you have been using bi-level with PS of 8 for many years.

Quote:The data sent over the cellualar service is mainly compliance, settings and basic AHI data in encrypted for to a Resmed operated site where your doctor or DME can retrieve the data. Your machine also produces detailed waveform data and a breakdown of apnea events. This is recorded on the SD card and is not transmitted.

The wireless modem in AirSense 10 and AirCurve 10 models also transmits "Detailed Data" such as Leak, Pressure, Respiration Rate, etc., but only one measurement per minute. The SD card holds 30 measurements per minute, allowing you to zoom in and see what's happening much more clearly.

In addition, the SD card stores around 1500 measurements per minute of the "High Rate" data like the "Flow" (estimated rate of airflow into or out of our lungs). Having the Flow data is needed if we want to double check that the apneas being scored by the machine are real apneas, not artifacts of quickly-varying Leak or something like that. The High Rate data is not sent over the modem, at all.

So there is more data on the SD card, which would be useful if the doctor were to be trying to figure out a problem (if you were having a problem).

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.

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